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General NPI Number Information
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NPI Number | 1184922049
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Entity Type | Individual
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Provider Name | VERNET MCCLARY
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Gender | Female
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 469 ROBINS EGG DR
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City | COLUMBIA
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State | SC
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Zip | 29229-6814
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Country | US
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Telephone | 803-546-3947
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Fax | 803-708-8009
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Provider Business Mailing Address
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Address Line | 469 ROBINS EGG DR
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City | COLUMBIA
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State | SC
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Zip | 29229-6814
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Country | US
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Telephone | 803-546-3947
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Fax | 803-708-8009
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 2011-41461-40612
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License Number State | SC
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